Objective: To determine the prevalence of metabolic syndrome (MetS) and the clinical utility of fat mass percentage (%fat) and estimated glucose disposal rate (eGDR) for predicting MetS in children and adolescents with type 1 diabetes (T1D).
Method: We conducted a descriptive, cross sectional study including T1D patients between 818 years of age. Modified criteria of IDF, WHO and NCEP were used to determine the prevalence of MetS. eGDR, a validated marker of insulin sensitivity, was calculated using A1C, hypertension status and waist-to-hip circumference ratio. %fat was determined by bioelectrical impedance analyses. ROC curve analysis was performed to ascertain cut-off levels of eGDR and %fat for predicting MetS.
Results: The study included 200 patients with T1D (52% boys, 48% girls). Of these, 18% were overweight/obese (BMI SDS ≥1.1). MetS prevalence was found as 10.5, 9.5 and 10.5% according to IDF, WHO and NCEP criteria respectively. There were no statistically significant differences in age, gender, family history of T2D, pubertal stage, duration of diabetes, A1C levels and daily insulin doses between patients with or without MetS. LDL-cholesterol and triglyceride concentrations are higher in patients with than without MetS (P<0.001). Lower eGDR levels, indicating greater insulin resistance, were found in MetS patients compared with those without (6.41±1.86 vs 9.50±1.34 mg/kg per min) (P<0.001). An eGDR cut-off level <8.24 mg/kg per min showed 81% sensitivity and 87% specificity for MetS diagnosis. Fat mass was significantly higher in MetS patients compared with those without (29.7±7.8% vs 21.2±7.9%) (P<0.001). A %fat level of 27.9 had 76% sensitivity and 80% specificity for MetS diagnosis.
Conclusion: Prevalence of MetS in our pediatric T1D cohort is not as high as reported in the other studies likely owing to relatively lower rate of overweight/obesity. Compared with other clinical variables, eGDR is a good indicator of diagnosing MetS.
Funding: This work was supported by the Scientific Research Council of Ondokuz Mayis University (PYO.TIP.1904.15.017).
01 Oct 2015 - 03 Oct 2015